The Canadian Mental Health Association (CMHA) is a strong supporter of the need for a strong consumer voice in all aspects of mental illness/mental health policy, planning, and delivery – from participation to decision-making to choice.
As articulated in CMHA’s Framework for Support model, consumers – that is, people who have had direct experience with the mental health system – can, with the right mix of services and supports, begin the journey to recovery. Recovery in this context is a nuanced phenomenon that may coexist with ongoing symptoms. Often described in terms of gaining control over one’s life and the illness, recovery is supported by elements such as meaningful daily activity, positive family or peer relationship, medications and recovery-oriented mental health services.
The person, not the system, must be the focus of policy. The person experiencing a mental illness must have opportunities to be an active participant in the community, withdecision-making power about which formal services or informal supports, if any, are the most appropriate at any given point in time.
Consumers themselves are an important resource. Organized in groups and with adequate financial support and organizational training where necessary consumers can collectively meet many of their mental health needs.
Within this category, self-help/mutual support is the longest standing and perhaps the most obvious activity. In recent years, other initiatives that consumers themselves control have expanded beyond self-help/mutual support groups to include consumer-run advocacy groups and networks, consumer-operated businesses, consumers training consumers in skills development and consumers developing a base of knowledge for themselves.
Families are the single largest group of caregivers, often providing financial, emotional and social support, although their role generally goes unrecognized. Families, when organized, have the potential not only to support their ill relative, but to provide support to one another and to other families as well. Families receive almost no financial support. For many people, informal networks of friends or neighbours fill the same functions as families. These networks provide a variety of kinds of support and the opportunity for reciprocal relationships not usually found in the system of formal services.
People with serious mental health problems, like everyone else, need to be connected to the natural community through a web of supportive contacts. Without the fundamentals such as jobs or other productive activities, good housing, appropriate education and adequate incomes, people are pushed to the margins of society and deprived of the kinds of support that they need if they are to survive the challenges of living with a mental illness. In addition, there are also other important factors, such as recreation and leisure, which contribute to a full life in the community.
All services and supports must work to connect people to these fundamental elements and thereby enhance their role as a citizen. These citizenship elements such as housing, employment, education, and income can also be seen as a grouping of social factors that determine mental health, consistent with the health determinants that have been identified through CMHA’s Citizen for Mental Health project and by the Public Health Agency of Canada and Health Canada.